Dale's Review Concepts II Flashcards
___ = Unicellular organism that harm the body by producing endotoxins & exotoxins
Bacteria
____ = obligate intracellular parasites
Viruses
Endotoxins VS exotoxin
Endotoxins = poisonous/harmful stuff in bacterial cell wall = inflammation, sepsis, etc.
Exotoxin = poisonous/harmful stuff is Ed bacteria, when released outside = cause damage
What are pyrogens?
Messengers released from WBCs that tell hypothalamus to make fever
Name the 5 P’s for assessing an Arterial Occlusion
Pain Pulseless Pale Parenthesia Paralysis
What is Claudication?
Cramping pn (usually in calves) gets worse w/ exercises, goes away w/ rest DT ischemia from Clot
_____ = a group of mental disorders = reality distortion, social withdrawal, disturbed thoughts/emotions/perception.
Schizophrenia
You have a psych pt you suspect is schizophrenic. At what age does this disorder usually start
Early adulthood
What’s Boyles law?
- think: Boyle = bottle. A small O2 bottle really high pressure. Big bottle does not*
Boyles law = volume gas inverse to it’s pressure
What’s Dalton’s Law
*Think: Dalton… ALL IN 100%”
Dalton’s law = sum of ALL partial pressures IN a gas = 100%
What’s Henry’s law
- think: Henry = Tennessee. They drink coke in Tennessee. Co2 in a coke can bubbles to top of coke can”
Henry’s law = concentration of gas in liquid = partial pressure of gas above liquid
What’s Charles law?
- Think: Charlie and the Chocolate factory. Wonka rides an air balloon. Air expands w/ heat.*
Charle’s law = vol. of gas expands w/ heat (gets smaller w/ cold)
What is prinzmetal Angina?
Angina that happens DT coronary artery vasospasm. From stress, exercise, hyperventilation, cold weather.
Pt fell asleep outside in winter, currently has CC: numb foot that appears yellow, white w/ mottled blue spots. What is wrong? What RX?
Frost bite.
Rx = splint, dry loose dressing, no let pt use it/stand on it, don’t rewarm it unless MCP tells you too.
Frost nip vs Frost bite
Frost nip = mild form, numb/tingling, easily reversible
Frostbite = full ischemic injury DT frozen tissue
Superficial vs Deep frost Bite
Superficial = Underlying tissue remains soft (numb burning tingling)
Deep = yeah. Yellow/white/mottled blue, numb = gangrene later
Trench foot vs frost bite
Trench foot same as frost bite but DT long cool/wet exposure. Can happen @ higher temps like 60F
Pt has itchy red/purple lesions on body after prolonged cold exposure. What is it?
Chilblains
What conditions & meds make a pt more susceptible to hypothermia?
Hypothyroidism Hypoglycemia Immobile Over aggressive Heatstroke Rx Any med that vasodilates
How do trauma pts lose a lot of heat?
Direct contact w/ ground/pavement
Typical SS of hypothermia
Stumble, mumble, fumble, grumble
What temp range is mild hypothermia and what SS?
What Rx?
95-90F (35-32)
All the umbles (stumble, mumble, grumble, fumble)
Rx = passive warming (blankets + heater)
What temp range is moderate hypothermia? What SS?
What Rx
90-82F (32-28)
Pt shivering stops
Osborn waves @ 90F
Rx: Active external warming
What temp range is severe hypothermia?
What Rx
75-68F (24-20)
Rx = warm fluids
Hypothermia can be confused with what other emergencies?
CVA, TBI, ETOH, psych
How would you Rx a hypothermic cardiac arrest differently from a normal one?
No vaso pressures until pt at 86F (check local protocol)
True or false: rough handling of a hypothermic pt can cause vfib.
False. No evidence of this
You must always resuscitate a hypothermic cardiac arrest pt. What are exceptions to this?
Submersion in water >1 hr (unless icy)
CBT < 50F
Frozen so stiff, compressions not possible
What is a toxidrome?
Groups of poisonings that have the similar/predictable SS
What are the 5 toxidromes
Narcotic Sympathomimetic Sedative-hypnotic Cholinergic Anticholinergic
Pt has Resp depression, pinpoint pupils, Brady, sleepy/coma, IV tracks. What toxidrome?
Narcotic
Pt has fight/flight SS, hyperthermic, paranoia, HTN, seizures, cardiac dysrhythmias. What toxidrome?
Sympathomimetic
Pt has respiratory depression, sleepy, w/ normal pupils. What toxidrome?
Sedative-hypnotic. Only narcotics will make pinpoint pupils
Pt has DUMBELS or SLUDGEM SS. What toxidrome
Organophosphate
Pt is red, dry, hyperthermic, and altered/delirious. What toxidrome?
Anticholinergic.
Think “red as a beat, dry as a bone, hot as a hare, mad as a hatter”
What drug class: stimulants
Sympathomimetic s (uppers)
What drug class is marijuana
Sympathomimetic
What drug class is ETOH
CNS depressant
How can you tell if someone OD on a barbiturate or benzo?
Similar to alcohol/Drunk SS
Classic SS of a cyanide poisoning
Smell of almonds
Rape drugs are what class of drugs?
Strong Benzos
How does hydrofluoric acid/ hydrogen fluoride affect the body? What Rx?
It leaches Cations from you = lethal & quick death
Rx = cations (Na, Ca, K)
What lethal dysrhythmia can a tricyclic antidepressant develop into? What is the Rx?
Rx = sodium bicarb
Tricyclic OD can = torsades. At this point, use mag sulfate
What is a salicylate? How does an OD affect the body?
Salicylate = analgesic like aspirin.
OD = metabolic acidosis
Why cant you give aspirin to kids?
Reye’s syndrome = cerebral edema & liver failure
What happens when you OD on Tylenol (acetaminophen)?
NV = pn = metabolic acidosis & AKF
___ = fluid builds up in pericardial sac & compresses the heart, disrupting CO
Pericardial tamponade
You suspect a pt has pericardial tamponade. What SS to look for?
What Rx?
Beck’s triad:
JVD, muffled heart sounds, narrowing pulse pressure (early sign), hypotension
Rx =. Fluids PRN to maintain CO. Pt needs a pericardialcentesis
What’s Cauda Equine Syndrome?
Compression of nerve bundle @ end of spinal cord (L1) DT trauma, tumor, infection, herniation = neuro/bowel issues
Pt had recent MVC w/ Low back injury. Now has SS: low back pn, loss of sensation/motor function in legs, ACUTE BLADDER/BOWEL ISSUES. What’s wrong?
Cauda Equine Syndrome
What is autonomic dysreflexia?
Parasympathetic NS doesn’t work below spine injury = sympathetic overdrive
Pt had a spinal cord injury above T4-T6. After some time, pt now has SS: HTN, seizure, Brady, chills w/ no fever, blurred vision, dilated pupils, dysrhythmias. What’s wrong?
Autonomic Dysreflexia. His sympathetic NS is in overdrive
Explain the “nail in Back” (Brown-Sequard syndrome_
Partial damage to spinal cord DT penetrating trauma or ischemia (lesion/tumor/clot) = SS to involved side
Pt has ipsilateral motor loss & contralateral pn/temp sensation below the site of a spinal injury. What’s wrong?
Brown-Sequard syndrome
What is HONK/HHS ?
Hyperosmolar nonketotic coma = hyperglycemia (>600 mg/dL) for DM type II
What is DKA?
Diabetic ketoacidosis = hyperglycemia (>350/400 mg/dL) for DM type I
HONK vs DKA
Both are hyperglycemia. HONK is for type II, DKA for type I.
In HONK, there is still insulin & glucose = no ketones in blood
DKA = no insulin = ketones & acidosis
Pt takes amaryl & metformin and had a recent infection. Now has SS: altered, hypotensive, dry warm skin. What’s wrong? What Rx?
Pt has DM Type II (ex. Metformin) & got an infection which spiked his BGL into HONK. He’s now severely dehydrated as a result.
Rx = secure airway & aggressive fluid resuscitation (500ml bolus)
Type I vs Type II DM
Type I = congenital or after 30. Autoimmune response destroys beta cells = no insulin
Type II = Hyperglycemia DT insulin resistance from poor lifestyle
Pt has polyuria, polydipsia, hypotension, AMS. No glucose in urine. What’s wrong?
Diabetes insipidus
What is diabetes insipidus?
Body can’t keep fluids DT lack of ADH or kidney issue = dehydration, electrolyte imbalance
Useless growth in body from cellular mutation (cancer of brain/spinal cord). What is it?
A neoplasm